GAO Analysis of Nursing Home Abuse

GAO’s latest analysis of nursing home abuse highlights the need for vigilance to protect vulnerable residents. The recent analysis reports the number of abuse cases in nursing homes has more than doubled in recent years. In its report, the GAO issued recommendations to help make these facilities safer.

Citations for Abuse

There are currently over 15,000 nursing homes in the United States. In all, these facilities house more than 1.4 million residents. As the population of the country ages, it is expected the numbers or nursing facilities and residents who depend on them for safe and reliable care will rise significantly in the coming decade.

To protect nursing home residents, the Centers for Medicare and Medicaid Services (CMS) works with state agencies to investigate incidents of elder abuse within these facilities. From 2013-2017, the number of citations more than doubled. 

The GAO analysis of abuse reported to CMS shows that 46% of instances involve physical abuse. These include pushing, hitting, striking, or restraining residents. 44% of instances of abuse involved mental/verbal assaults. A total of 18% of abuse cases involved sexual assaults.   

The data also showed that abuse doesn’t come from one type of perpetrator. CMS data shows that 58% of abuse cases involved staff members. Approximately 30% involved residents. About 2% involved “others” including visitors to the nursing home, vendors, etc. 

Alarmingly, GAO determined that there are significant gaps in CMS oversight procedures. As a result, it is highly likely that the total number of instances, and the types of incidents occurring, are significantly underreported. 

Curbing Future Abuses

The GAO has recommended the following actions in the belief that these changes will reduce instances of abuse within nursing home facilities. According to recommendations, CMS should:

• Require that the type of abuse and the perpetrator type be reported to state agencies to help establish trends and patterns of abuse.
• Develop and distribute standardized forms for reporting incidents of elder abuse.
• Require all state agencies to immediately report abuse to law enforcement. In instances of Medicaid fraud, reports should also be made to Medicaid Fraud Control Units (MFCU.) 
• Provide guidance regarding the information that should be contained within reports made to law enforcement or the MFCU.